Georgia : COVID-19 Emergency Response Project

Project Name

COVID-19 Emergency Response Project

Project Number

54457-001

Country / Economy

• Georgia

Project Status

Closed

Project Type / Modality of Assistance

• Grant

Source of Funding / Amount

Grant 0773-GEO: COVID-19 Emergency Response Project

Source	Amount
APDRF Government of Japan for COVID19	US$ 2.50 million

Operational Priorities

• OP1: Addressing remaining poverty and reducing inequalities
• OP3: Tackling climate change, building climate and disaster resilience, and enhancing environmental sustainability
• OP6: Strengthening governance and institutional capacity

Sector / Subsector

• Health /

Gender

No gender elements

Description

Despite significant improvements in recent years, Georgia's public health system remains vulnerable to the health burden posed by the COVID-19 pandemic and crisis. The health sector capacity is limited, physical health infrastructure is inadequate, and there is a lack of trained medical personnel to respond to the COVID-19 pandemic. Out-of-pocket spending has been declining after the introduction of the Universal Healthcare Program in 2013, but still accounted for 54.8% of total health spending in 2017. This points to an underlying vulnerability for low income groups, which are particularly at risk as COVID-19 unfolds. About 17.5% of Georgia's population is older than 60 years, while 3.3% of the population is older than 80 years. This poses additional challenges in dealing with the COVID-19 emergency since evidence from other countries suggests that the older populations, especially those with pre-existing health conditions, are at higher risk of contracting the disease and, if infected, often require more intensive care.

According to the Global Health Security Index, Georgia's health capacity in clinics, hospitals and community care centers scores low: 18.3 out of 100. This is largely due to the deficit of nursing staff and low hospital bed density. Georgia has only 47.3 nurses per 10,000 population and 26 hospital beds per 10,000 population compared with neighboring countries such as Armenia which has 42 beds per 10,000 population. Critical skills gaps exist in Georgia's healthcare sector and a number of health workers and laboratory staff have to be trained to be able to respond to COVID-19. Some 62% of frontline medical doctors, who are higher risk of infection, are women.

With the acceleration of virus transmission rate since September 2020, Georgia's health system is increasingly overwhelmed. According to MoILHSA, as of the second week of November, about 4,500 beds in more than 30 hospitals were already occupied by COVID-19 patients, while only 250 beds were available. The Ministry is working to increase the number of beds available for COVID-19 patients to 8,500 by early December. Health workers are increasingly contracting the disease. The number of infected health workers surpassed 1,700 or 5% of total number of infected as of end October 2020. More resources are needed for management of severe cases, prevention of onward virus transmission and alleviation of strains on health-care services. The government needs support to augment its capacity and constrained financial and human resources to ensure effective and timely lifesaving efforts and respond to the impact of COVID-19.

The proposed support from the APDRF will help finance immediate needs and deliver appropriate medical services where required. The government has indicated ADB's support would be used for improvement of laboratory diagnostic and testing capacity, procurement of personal protective equipment and other medical equipment to help the government meet its most urgent needs. Recognizing the unpredictable nature of the situation and the concurrent inflow of support from other sources, flexibility is required, along with close coordination with various sources and partners. Any supplies funded from APDRF grant will be coordinated with other support from development partners to avoid duplication.

The APDRF grant will complement ADB's comprehensive package of support to Georgia designed to contain COVID-19 impact. The package includes a $100 million loan approved in May 2020 and a $200 million loan approved in October 2020 to respond to Georgia's immediate health and socioeconomic needs and support a return to inclusive economic growth by addressing the longstanding institutional fragilities in social protection, fiscal and debt management that were exacerbated by the pandemic. ADB has also provided grant support to Georgia in August 2020 to procure PCR equipment for the COVID-19 health response, funded under the regional technical assistance project. The new equipment will augment Georgia's PCR testing capacity and help the authorities to better trace and contain the spread of the virus.

Project Rationale and Linkage to Country/Regional Strategy

Considering the substantial impact of COVID-19 and the government's constrained resources, it is recommended that an amount of $2.5 million is provided to the government as a grant financed by the APDRF, and up to 30% of the grant amount can be used retroactively for eligible expenditures incurred prior to grant effectiveness, but not earlier than 22 October 2020.

The Climate Change and Disaster Risk Management Division (SDCD), Sustainable Development and Climate Change Department (SDCC) has been consulted and, in consultation with the Health Sector Group, SDCC confirmed that the conditions for assistance have been met and that there are sufficient balances available under the APDRF to meet the proposed grant (attachments 5 and 6).

Impact

Project Outcome

Description of Outcome

Progress Toward Outcome

Implementation Progress

Description of Project Outputs

Status of Implementation Progress (Outputs, Activities, and Issues)

Geographical Location

Nation-wide

Safeguard Categories

Environment

C

Involuntary Resettlement

C

Indigenous Peoples

C

Summary of Environmental and Social Aspects

Environmental Aspects

Involuntary Resettlement

Indigenous Peoples

Stakeholder Communication, Participation, and Consultation

During Project Design

During Project Implementation

Contact

Responsible ADB Officer

Kiziria, George

Responsible ADB Department

Central and West Asia Department

Responsible ADB Division

Georgia Resident Mission (GRM)

Executing Agencies

Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs (MOILHSA)

Timetable

Concept Clearance

-

Fact Finding

26 Nov 2020 to 26 Nov 2020

MRM

08 Jan 2021

Approval

03 Dec 2020

Last Review Mission

-

Last PDS Update

03 Dec 2020

Funding

Grant 0773-GEO